HIV and India: Intelligence + Ignorance = Unfair Treatment

Addendum: Could India learn something from Brazil? You make the call. Banning sex education on the grounds that it offends Indian sensibilities puts young lives at risk and jeopardizes the fight against a senior health official said. Six states in India, which has the most people living with HIV/AIDS in the world, have banned sex education for adolescents or refused to implement the curriculum, saying the course material was too explicit or that it was against Indian culture. For full article, click here.

On April 1, 2007, India will launch a new phase of its National AIDS Control Program (NACP). Its goals include reducing the number of new human immunodeficiency virus (HIV) infections — currently, an estimated 98.5 to 99.5% of India’s 1.1 billion people remain uninfected — improving treatment, and providing therapy to more people. The 5-year program, known as NACP-III, has a budget of about $2.6 billion, two thirds of which is earmarked for prevention and one sixth for treatment (with the remainder primarily for management), and represents a substantial increase in the attention to and spending on HIV–AIDS.

How does this relate to you?

Each year, about 28 million children are born in India. Skilled health care personnel attend less than half of all births; infant mortality is about 55 per 1000 live births. In 2004, only an estimated 4% of all pregnant women received HIV counseling and testing, and only about 2% of HIV-positive pregnant women received antiretroviral prophylaxis, usually consisting of a single peripartum dose of nevirapine. Moreover, HIV-positive pregnant women may benefit from antepartum combination antiretroviral treatment for their own health. Under NACP-III, more pregnant women should receive monitoring of their CD4 cell counts, antiretroviral treatment, regimens designed to prevent HIV transmission (including combinations of antiretroviral drugs), and other services.

In India, as in much of the world, stigma and discrimination present major barriers to controlling AIDS. In 2005, the HIV–AIDS unit of the Mumbai-based Lawyers Collective, which provides free legal aid, drafted comprehensive antidiscrimination legislation. This means unfair treatment, and this is especially so for women as you see in the video.

In scaling up treatment, India’s domestic pharmaceutical industry has a critical role. A paradox is that Indian companies have become major suppliers of low-cost generic antiretroviral medications to low- and middle-income countries in Africa and elsewhere at a time when there are still major unmet needs for HIV treatment in India. Cipla, a company based in Mumbai, manufactures the largest range of HIV drugs and has the largest market share. Cipla exports 18 times as much antiretroviral medication as it sells domestically, according to Amar Lulla, its joint managing director. Retail drug prices are higher in India than in Africa, in part because of taxes. Eventually, enhanced patent protection for pharmaceuticals in India, which took effect in January 2005, may lead to higher prices. Do you know of local, regional or global organizations helping to address this problem? Please share with the community? What is your solution?